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General NPI Number Information
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NPI Number | 1811372600
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Entity Type | Organization
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Legal Business Name | RENEWMD COASTAL, INC.
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 6260 EL CAMINO REAL
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City | CARLSBAD
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State | CA
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Zip | 92009-1609
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Country | US
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Telephone | 760-476-2953
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Fax |
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Provider Business Mailing Address
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Address Line | 6260 EL CAMINO REAL
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City | CARLSBAD
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State | CA
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Zip | 92009-1609
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Country | US
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Telephone | 760-476-2953
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SHARON SLOWIK
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Credential | M.D.
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Telephone | 760-803-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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